Friday, November 20, 2009

Mammogram madness - where is the objectivity?

A raging debate has emerged in the US over the recent release of the report by the U.S. Preventive Services Task Force (USPSTF) revising the recommendations for screening mammograms in women between 40-50 years of age. Stridently vocal critics of the report argue that this was part of some cost cutting measures, and that relaxation of these guidelines would lead to breast cancers not being detected early in these women and consequently more cancer deaths. The trouble with the arguments from these critics was that there was little to offer other than anecdotes.

The debate did focus my attention on how difficult it is to get truly objective information. I don't really know too much about who is right in this debate, but it did seem to me that at least the Task Force did try and base their findings on objective scrutiny of evidence. What disappointed me was that the major physician and oncology groups just lent their voices to the din by adding more and more anecdotes to support screening. Where is the objectivity? Where is this much touted 'evidence-based' medicine? (see NPR Report)

My question is, can we count on doctors to be objective in their recommendations? Can we even count on governmental reports to be objective given that governments themselves have become players themselves in this game of medical monopoly.

In a recent CNN report Alice Park writes: "If the brouhaha following a government advisory panel's recent change in breast-cancer-screening recommendations has proved anything, it is that even modern medicine does not rely on statistics, scientific facts and clinical outcomes alone."

How true. How sad. Oncology groups tend to gain by increasing hype and hysteria since they result in more screening, and more early treatment revenues.

This debate will not end soon. So far the Ministry of Health and Health Promotion Board have remained silent. How objective will they be, I wonder?